Primary Hyperparathyroidism due to Parathyroid Adenoma in Children and Adolescents

•Primary hyperparathyroidism (PHPT) in children and adolescents is a rare endocrine disorder. •Unlike adults, most pediatric patients with PHPT were symptomatic, experiencing various symptoms related to hypercalcemia. •Diagnosis primarily relied on ultrasound and Tc-sestamibi scan, demonstrating high sensitivity in detecting single parathyroid adenomas. •Minimally invasive parathyroidectomy with intraoperative measurement of PTH levels was the main treatment approach, preceded by the normalization of serum calcium levels. •Two patients were diagnosed with PHPT following treatment with human recombinant growth hormone for idiopathic short stature, suggesting a possible association. Background In contrast to adults Primary hyperparathyroidism (PHPT) in children and adolescents, is a rare endocrine disorder. Methods A retrospective review of PHPT cases between 2005-2022 from a single tertiary university medical center, including clinical signs and symptoms, laboratory findings, radiological evaluation, treatment, and post-operative complications. Results Ten children (Mean age at diagnosis 16.3±1.3 years) were diagnosed with PHPT. All patients were in late pubertal stages without sex predominance, and eight were symptomatic. Mean calcium level was 13.6±2.5 mg/dL, and mean parathyroid hormone (PTH) levels were 204.8±163.1 pg/ml. Parathyroid adenoma was confirmed by the post-surgical pathology results. Conclusions PHPT in children and adolescents is often symptomatic and more severe than adults. The main cause is single parathyroid adenoma. Associated hypercalcemic syndromes were not found. Patients were cured after surgical removal of the adenoma without significant post-operative complications and no recurrence during 10.4±5.9 years follow up. In contrast to adults Primary hyperparathyroidism (PHPT) in children and adolescents, is a rare endocrine disorder. A retrospective review of PHPT cases between 2005-2022 from a single tertiary university medical center, including clinical signs and symptoms, laboratory findings, radiological evaluation, treatment, and post-operative complications. Ten children (Mean age at diagnosis 16.3±1.3 years) were diagnosed with PHPT. All patients were in late pubertal stages without sex predominance, and eight were symptomatic. Mean calcium level was 13.6±2.5 mg/dL, and mean parathyroid hormone (PTH) levels were 204.8±163.1 pg/ml. Parathyroid adenoma was confirmed by the post-surgical pathology results. PHPT in children and adolescents is often symptomatic and more severe than adults. The main cause is single parathyroid adenoma. Associated hypercalcemic syndromes were not found. Patients were cured after surgical removal of the adenoma without significant post-operative complications and no recurrence during 10.4±5.9 years follow up.